Sometimes anxiety is obvious (think: panic attacks and sweaty palms), but that’s not always the case. Many people live with a form called “high-functioning anxiety.” Outwardly, they appear to have it all together. They may even lead very successful lives. No one can tell from the outside that they’re driven by fear. Sometimes they don’t even realize it themselves.

Although not an official diagnosis, high-functioning anxiety is something many people identify with. It’s closely related to Generalized Anxiety Disorder, which affects 6.8 million adults in the U.S., with women twice as likely to experience it as men.

15 Signs of High-Functioning Anxiety

1. You’re always prepared.

Your mind frequently jumps to the worst-case scenario in any given situation. As a result, you may find yourself over-preparing. For example, you might pack underwear and makeup in both your checked luggage and your carry-on, just in case the airline loses your suitcase. People see you as being the reliable one — your preparations often do come in handy — but few people (if any) realize that your “ready for anything” mentality stems from anxiety.

2. You may be freaking out on the inside, but you’re stoic on the outside.

Interestingly, many people with high-functioning anxiety don’t reveal just how nervous they are, which is another reason why it’s often a secret anxiety. You may have learned to compartmentalize your emotions.

3. You see the world in a fundamentally different way.

Your anxiety isn’t just "in your head.” Researchers from the Weizmann Institute of Science in Israel found that people who are anxious see the world differently than people who aren’t. In the study, anxious people were less able to distinguish between a safe stimulus and one that was earlier associated with a threat. In other words, anxious people overgeneralize emotional experiences — even if they aren’t threatening.

4. You constantly feel the need to be doing something.

This can be a real problem if you’re an introvert who needs plenty of downtime to recharge. This doesn’t necessarily mean you’re attending lots of social events; instead, you may feel a compulsion to always be getting things done or staying on top of things. Staying busy distracts you from your anxiety and gives you a sense of control.

5. You’re outwardly successful.

Achievement-oriented, organized, detail-oriented, and proactive in planning ahead for all possibilities, you may be the picture of success. The problem is, it’s never enough. You always feel like you should be doing more.

6. You’re afraid of disappointing others.

You might be a people-pleaser. You’re so afraid of letting others down that you work hard to make everyone around you happy — even if it means sacrificing your own needs.

7. You chatter nervously.

Even though you’re an introvert who prefers calm and quiet, you chatter on and on — out of nervousness. For this reason, you're sometimes mistaken for an extrovert.

8. You’ve built your life around avoidance.

You’ve shrunk your world to prevent overwhelm. You stick to routines and familiar experiences that give you a sense of comfort and control; you avoid intense emotional experiences, like travel, social events, conflict, or anything else that might trigger your anxiety.

9. You’re prone to rumination and overthinking.

You do a lot of negative self-talk. You often replay past mistakes in your mind, dwell on scary “what if” scenarios, and struggle to enjoy the moment because you’re expecting the worst. Sometimes your mind races and you can’t stop it.

You try to calm your worries by getting your work or your appearance just right. This can bring positive results, but it comes at a cost. You may have an “all-or-nothing” mentality (“If I’m not the best student, then I’m the worst”). You may have unrealistic expectations of yourself, and a catastrophic fear of falling short of them.

11. You have aches, repetitive habits, or tics.

According to psychotherapist Annie Wright, your anxiety might manifest physically in your body as frequent muscle tension or aches. Similarly, you might unconsciously pick at the skin around your nails, tap your foot, scratch your scalp, or do other repetitive things that get your nervous energy out — even if you appear composed in other ways.

12. You’re tired all the time.

Your mind is always going, so you have trouble falling asleep or staying asleep. Even when you sleep well, you feel tired during the day because dealing with a constant underlying level of anxiety is exhausting.

13. You startle easily.

That’s because your nervous system is in overdrive. A slammed door, an ambulance siren, or other unexpected sounds really rattle you.

14. You get irritated and stressed easily.

You’re living with constant low-level stress, so even minor problems or annoyances have the power to frazzle you.

15. You can’t “just stop it.”

Anxiety isn’t something you can tell yourself to just stop doing. In fact, the researchers from the Weizmann Institute of Science found that people who are anxious have somewhat different brains than people who aren’t. They noted that people can’t control their anxious reactions, due to a fundamental brain difference. (However, you can learn to cope with your anxiety and greatly lessen it . See the resources below to help you get started.)

I never recognized myself as having anxiety, until I started therapy for a different issue. After having read this list and relating to all 15 points, it makes a lot of sense that from an outsider I looked like I had it together but internally I was often very anxious. Therapy has helped me have a better understanding of what my anxieties are and I have more self-confidence to slowly work on my fears.

I might have been labelled an 'introvert'. I might have been described as 'anxious'. Why? I got compared to everyone else. Why do they do that? So, unsurprisingly, i dot not willingly agree with everything in Jenn Granneman's article. For example, when she describes 'introversion' as needing 'miminal stimulations' - she infers that the environment sought by the introvert does not provide much stimulation. Not always true. You can't be a perfectionist if your environment is not perfect. I could have listened to Wagner all day and felt I needed nothing else! (NOTE: I'm not a keen fan of Wagner). When a person (who might have been previously introverted) gains more confidence.......everything changes, because others will have had the same perceptions for years. Consider this: Introversion + Empathy = Extroversion. To what extent would you agree?

To answer your final question, Mr. Hart, I can't agree in the slightest. Here is my reasoning.
For one thing, I am a highly empathetic introvert, as are most of my friends-- the two are by no means mutually exclusive. We are "Introversion + Empathy"-- but we are decidedly not extroverts!
(Quick note: if I come off as derogatory towards extroverts, I sincerely apologize. Extroverts are often lovely people. I just don't happen to be one.)
One primary characteristic of introverts is a tendency to socialize in small, closely knit groups for limited periods of time. Within these groups, there is often a "web" of empathy, through which we connect and relate to one another in an often deep and meaningful way. In other words, "Introversion + Empathy"= tightly knit social circles and powerful relationships, which can also be experienced by extroverts but are not synonymous with extroversion.
Also, a brief aside: you mentioned that someone may be labeled an introvert until they gain confidence. Not necessarily. There are shy extroverts and ambiverts in the world, who may be misidentified until they become more confident. This is true. However, your comment can readily be misconstrued to mean ''introverts' just need to be more confident!' This is not the case. I personally know many introverts who also happen to be highly confident and comfortable with themselves.

I'm guessing, for extroverts, it's: extroversion + sympathy = sympathetic extroverts? Interesting, and so is your version. I think you might have comfortably re-interpreted my effort because I had not considered introverts as 'empathetic'. Empathy seems to be more readily understood in areas of Northern Europe than in areas like the UK. So I wasn't too keen to use the word, hoping that people would easily understand my use of the word 'confidence' (ie; people become empathetic when reaching conclusions about their characters but do not consciously use the word 'empathy' or think, for one moment, that their strategy was an 'empathetic' one). However, not too difficult for me to know your main message. Thanks.

First, what exactly do you mean by "Empathy seems to be more readily understood in areas of Northern Europe than in areas like the UK"? Are you inferring that people from the U.K. cannot, or are less likely to, understand empathy? And why do you bring geography up in the first place (nothing in the article or my comment had ANYTHING to do with geography; this seems like a random tangent)? I'm sure you have some reason for bringing geography into it, but what that reason is I can't discern. Please explain.

Second, while your definition of confidence is an interesting one, it is not-- I repeat, not-- the layman's definition. From whence did you derive it?

Quick note: For future reference, it would be helpful if, when you use a word in a different way than most people understand it, you define it in a brief parenthetical statement so readers can more accurately understand your point. Example: "Migration (movement of neurons to their proper place in the brain) is a critical phase of embryonic development." Without the parenthetical phrase, this sentence would seem to imply that embryos must fly south in the winter in order to develop properly.

Third, why hadn't you considered introverts empathetic?

An explanation of these three points would be greatly appreciated. Thank you.

Hello 'Anonymous'. To answer your question about the nature or popularity of empathy, there was an edition of a programme called 'Newsnight' (broadcast in the UK), often containing discussions, which included a suggestion - as part of a discussion - indicating that empathy, as a skill or part of one's personality, was not making itself well-known to those that may need it. The suggestion was not meant to be the result of a world view, a European view or a British view but part of a discussion which briefly explored human behaviour in certain sectors of society.
I note you use the word 'parenthetical'. My [bracketed] effort, in which readers were trusted to already know the meaning of the word 'confidence', was meant to explain HOW people gain(ed) confidence in which 'empathy' was or is an underlying (or subconscious) - dare I say it? - 'agent'.
Your last question: Would I be right to feel that everyone would consider introverts as 'empathetic'? I'm not sure. I'm inclined to say 'no' - introverts are not always considered as 'empathetic' by everyone. Psychology for mass appeal is vastly different from psychology for the individual. When taking part in a discussion forum, does one want to help the individual personality or help the audience (et cetera)? Suffice to say that how you helped could have been different to how I helped. Fair?

Mr. Hart, I sense you are a man of steadfast opinions. Please allow me to clarify a few points and make a suggestion or two.

1) Interesting. I'll have to listen to Newsnight's discussions of empathy; I'm sure they present some valuable insights and perspectives. In the future, it would help readers such as myself if you introduced the (fascinating, frankly) topic of how we understand empathy between cultures before discussing it; launching directly into a discussion tends to leave readers somewhat lost.

2) You wrote, "When a person (who might have been previously introverted) gains more confidence.......everything changes, because others will have had the same perceptions for years". This statement has nothing to do with empathy, and does not explain empathy in relation to confidence; rather, it makes a rather broad statement about false identification of introverts. Empathy in relation to confidence is a fascinating subject which I hope a qualified psychologist will address in a future post. However, the above quotation contains no reference to it.

3) That was not my question. It really wasn't. I asked WHY you hadn't thought of introverts as empathetic.
Please take the time to examine your own subconscious preconceptions; then, if you feel you can answer my actual question, I would love to hear what you have to say.

Many thanks for your latest 'observations'. I'm keen to accept parts of your numbered paragraphs (1 & 2) but if you're keen on knowing about 'subconscious preconceptions' (besides your own), then why not try the Spiritualist Church? (I'm not a member of this Church - for obvious, good , reasons.) You might connect with it in some way. Who knows?
Finally, when I discover that people are prepared to apply strange descriptions to their ailments, my subconscious will not be pre-occupied or busy regarding their idea - giving myself 'room' for happier - possibly musical - moments. But alas, 'Anonymous', you were not the first to make myself aware of the psychology of sentencing (!) and its effects. Many thanks for your replies and I hope you and your friends will continue to explore / study empathy because knowledge is one life's valuable gifts.

Thank you once again for your extraordinarily nebulous reply. While I am interested in hearing what incredible leaps of inference lead you to believe that introverts are, in general, not empathetic creatures, I am not interested in joining a religious organization at this time, especially not one you so readily condemn through paralepsis. Furthermore, I fail to see why you brought the subject up.
Until we meet again in another comments section, I bid you farewell.

Paralepsis? I think paralepsis refers to the nature of language in rhetoric. Some people might say that anything is 'rhetoric' if it does not look or sound familiar to them.
I do not believe I inferred that introverts are not empathetic and I'd like to say that I'm not a character, like you, who routinely describes people as 'creatures'. I could have simply said: yes, introverts are empathetic without asking how, when, or why introverts are empathetic. After all, there's no empathy without first discovering experiences that occur.
Interesting that you should use the word 'nebulous'. Astronomical? What happened to the parenthetical support for the word 'nebulous'?
Did I use the word 'condemn'? I think not. Farewell.

Yes, I have anxiety, but I usually blame it on my caffeine addiction. Driving is no fun because I'm constantly picturing worst-case scenarios which could lead to an accident, and driving on freeways requires you to trust the people around you to not do anything stupid. But this article makes no mention of what I should do about my high-functioning anxiety. I only have 14 of the 15; I don't think I chatter nervously, a lot of times I want to say something but hold off and don't get a chance.

I believe I am going through early perimenopause, and it is really the first time I noticed I experience anxiety because it has gotten so much stronger with perimenopause. Luckily, I have finally found a job that fits me very well and have been on that job for exactly one year tomorrow (the 13th), but prior to that I had so many issues with jobs and my career because of anxiety + introversion.

It seems like almost every job out there requires dealing with people all day long, and having worked in IT and customer service jobs it felt like I was always dealing with difficult people or worrying about if someone was going to be difficult or worrying about not knowing the answer to something. Being an introvert and having anxiety, my job preference is working by myself with minimal interaction with others, especially difficult people. I have never had a job for more than a year and a half, and I am 37--I think this is the first job that will work out. I am the kind of person whom other people wonder why I'm not more successful because I always end up quitting jobs over anxiety and stress. I always do great at those jobs but just am miserable and have to get out. I was a great student and attended universities that are of similar prestige to Ivy League schools, but anxiety has really messed up everything I thought my career and life would be after school.

So, unless an anxious introvert has found the right type of job for him/herself, I am not sure how they can appear to be successful to others. I definitely fit probably half of the 15, can fit some of the others at times, and I don't understand #3. I am very much a perfectionist, am always over-prepared and can never relax/stop thinking. Definitely startle very easily and am always tired/never get good-quality sleep. Always have to look like I'm doing something at work, and always tackle and complete tasks right away--everyone notices how fast I get stuff done. I think I come off as very intense at work, because I am.

We have a winner! I fit every sign of being an anxious introvert, solidifying what I’ve always suspected: I’m an introvert who happy thrives in her own little world while portraying a Chatty Cathy when around people because of my severe anxiety. I’ve been so confused because my chattiness belies who I knew I was. But give me a chance to sit in an empty room, staring out a lovely window, enjoying the company of me, myself, and I as my mind reels in ecstacy of a world that lives behind my eyes...it’s like a cloak has been lifted.

I totally understand what you are saying about being alone. I like being alone. I haven't said this in a long time, but I used to say that one of the reasons people feel compelled to fill all their time with unimportant busywork is that whenever they are alone, they don't like the company.

I identify with many of the items on the list (but not all; you still win) particularly with the fact that many people consider me an extrovert. I have been highly successful despite my constant low-level anxiety, which I didn't know I had until my regular doctor was on vacation, so I had to see a different one, who identified the multiple symptoms I was suffering from as cumulative stress-induced panic attacks.

Just hearing that made a big difference. I moved out of the position I was working in (to get away from an unreasonable manager) and into a middle-management job where I can contribute and be successful without the stress.

Funny, if we ever met, we'd probably be Chatty Cathy and Chatty Chad, when in reality we both might enjoy some quiet sharing time instead.

I really enjoyed this article. It describes me well. I'm over prepared because I fear the worst. I'm tired all the time. I avoid social situations. I startle easy. Most everything on the list applies to me. I'm happy to know I'm not alone. I wish I knew more people like me. Thank you for writing this article. I enjoyed reading all the comments. And by-the-way, I'm such an empathic introvert, I have to be careful about the emotional experiences I expose myself to because I can easily take on the feelings of another person and carry their burdens.

We live in a highly dysfunctional world. If you are functioning extremely well in a dysfunctional world, you might be .... well, properly (or improperly) medicated.

It's more than OK to have an anxious personality; it's rather normal in today's world. Humans were meant to be outside in sunshine, working with their hands and hearts, creating, building, nurturing & feeding others. Living our lives behind computers and devices desperately trying to reach deadlines and make others happy with us so that we can keep a job and pay our bills... unnatural existence. Not a surprise anxiety is through the roof for many people, introverted or not!

I found this article really interesting to read, and relate to a lot of them. Not all of them but still some of them strongly apply to me. It's couldn't be more true for me what you mention at first about preferring a minimal stimulating environment as an introvert.

But I also most particularly have the problem of chattering nervously, especially displaying lots of awkward fillers such as "errrr" and ermmm" and just messing up my words as I speak, or talking too much lacking punctuation. I hate it not just because I feel like such a socially awkward mess and worry people will think I'm weird or get impatient with me, finding me annoying, but also because like you mention I fear I may be mistaken for an extrovert because of this. Not that there's anything wrong with being an extrovert, but it's just annoying for me as it's not who I am and would not want to be mistaken for something I'm not.